Download - Raynaud’s phenomenon
Raynaud’s Phenomenon
Dr. Fardan QadeerDept. Of Pathology
CIMS and H
It is a vasospastic disorder causing discoloration of the fingers, toes, and occasionally other areas.
• Raynaud's phenomenon – Raynaud's disease (also known as "Primary
Raynaud's phenomenon") where the phenomenon is idiopathic
– Raynaud's syndrome(secondary Raynaud's), where it is caused by some other instigating factor, most commonly connective tissue disorders
PathogenesisExaggerated Vasomotor Response
STRESSCOLD
Sympathetic Stimulation
Vasoconstriction
HYPOXIA
Pathogenesis
Primary Raynaud’s
Raynaud's disease• Idopathic• It often develops in young women in their teens
and early adulthood. • Smoking worsens frequency and intensity of
attacks, and there is a hormonal component.• Caffeine also worsens the attacks. • Associations: migraine and angina
Secondary Raynaud's
Raynaud's syndrome • It occurs secondary to a wide variety of other
conditions. Secondary Raynaud's has a number of associations:
• Connective tissue disorders:– scleroderma– systemic lupus erythematosus– rheumatoid arthritis– Sjögren's syndrome– dermatomyositis– polymyositis
CynosisIschemia
PallorVasospasm Rubor
Clinical Features:
Chronic, recurrent cases of Raynaud phenomenon can result in atrophy of the skin, subcutaneous tissues, and muscle. In rare cases it can cause ulceration and ischemic gangrene.
Treatment• Secondary Raynaud’s: Treatment of underlying
Cause• Primary Raynaud's: Avoiding triggers.– Extreme Cold Exposure– Caffeine– Coffee– Avoidance of Emotional Stress
• Emergency Care:– allow tepid to slightly warm water to run over the
affected digits while you gently massage the area. Continue this process until the white area returns to its normal, healthy color.
– place the affected digits in a body cavity—armpit, crotch, or even the mouth. Keep the affected area warm at least until the whiteness returns to its normal, healthy color
– Vigorous hand movement will allow the blood circulation to increase
• Drug Therapy:– Calcium Channel Blockers– In a study published in the November 8, 2005
issue of Circulation, sildenafil (Viagra) improved both microcirculation and symptoms in patients with secondary Raynaud's phenomenon resistant to vasodilator therapy
– Fluoxetine, can be useful for management of emotional stress
• Surgery:– Sympathectomy